On Rs. 200/- Folio No. Certificate Nos. Distinctive Nos. Shares covered in each certificate
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1 On Rs. 200/- FORMAT OF INDEMNITY BOND FOR ISSUE OF DUPLICATE SHARES (Please type this indemnity bond after carefully reading the notes mentioned below the format) To, The Company Secretary, (Name of the Company ) Address of the Company WHEREAS I/We, (name of the shareholder(s), hold (Number of shares) Equity shares bearing Distinctive numbers from to of the face value of Rs../- each and on which Rs. /- per share is paid comprised in the Share Certificate No(s).. The shares of the following description are standing in my/our name in the Register of Members of the (name of the company). Folio No. Certificate Nos. Distinctive Nos. Shares covered in each certificate WHEREAS The share certificate(s) No(s). in respect of the above shares has/have been lost or mislaid and is/are not traceable. I/We declare that the said share certificate(s) was/were not accompanied by any blank transfer deed signed by me/us and that I/We have not, nor has any person by my/our order disposed off, parted with or pledged / deposited by way of security the said share certificate(s) or assigned my/our interest therein or any part have neither been sold or transferred to anybody by me/us and I/We am/are entitled to the custody of the certificate(s) of title relating to such shares as I/We am/are the absolute owners of the same as registered shareholder(s). I/We undertake to surrender the said share certificate(s) to the company if and when the same is/are found at a later date. NOW THEREFORE : I/We, (name of the shareholder(s) aged years, residing at (address of the shareholder/s) approach the Company to please issue duplicate share certificate(s) in lieu of the original shares covered under Folio No. and bearing Certificate No(s). held by me/us. In consideration of the Company having agreed to issue duplicate share certificates for the aforesaid shares in my/our name, I/we am/are executing a bond in favour of the Company. Upon the Company, having agreed to issued duplicate share certificates for the aforesaid shares, I/We the undersigned applicant(s) hereunder for myself/ourselves, my/our heirs, executors, administrators and assigns do hereby jointly and severally covenant with the Company, its successors and assigns and agree and undertake at all times save, defend and to indemnify and keep indemnified the Company, its successors and assigns its estate and effects, and its directors, manager, secretary and shareholders and their heirs, executors and assigns from and against all actions, suits, proceedings, accounts, claims and demands
2 whatsoever for or on account of the said shares or dividends or any part thereof or otherwise in connection with the same, and from and against all losses, costs, claims, actions, demands, risks, charges, expenses, damages and losses arising in any manner howsoever. IN WITNESS WHEREOF I/We, the applicant(s) herein has/have signed and set my/our hands on this day of. Name and address of the Shareholder(s) 3. Signature of the Shareholder(s) Name and address of Witness Signature of the Witness Place ; Date :
3 SURETY We, (name of the surety No.1) aged years, residing at (residential address of Surety No.1) and having business address at (official address of Surety No.1), having PAN No. and (name of the surety No.2) aged years, residing at (residential address of Surety No.2) and having business address at (official address of Surety No.2), having PAN No, the undersigned, certify that the above facts are true to the best of our knowledge. We bind ourselves sureties to make good all claims, charges, costs, damages, demands, expenses and losses which the Company, its successors and assigns its estate and effects and its directors, manager, secretary and shareholders may sustain, incur or be liable for in consequence of complying with the request contained above and the Company, its successors, assigns, directors, manager, secretary and shareholders will be entitled to realise all claims, charges, costs, damages, demands, expenses and losses from our persons and our properties, as the case may be. Place : Date: Name and Address of the Surety Signature of the Surety Name and Address of the Witness Signature of the Witness NOTES: Indemnity Bond should be on Non-judicial stamp paper of Rs.200/-. Please fill up the details as per the documents you are annexing. Please do not just type this format as it is. 3. Indemnity Bond should be witnessed by two persons. 4. Two sureties are required to be furnished 5. Witness and Surety have to be different individuals. 6. Each Surety has to attach attested copy of his PAN Card and Form 16 of the latest financial year and attested copy of his proof of identification viz. Ration Card, Election Card, Driving Licence, Passport, Electricity Bill, Telephone Bill, etc. 7. Indemnity Bond should be attested by Notary
4 FORMAT OF AFFIDAVIT FOR VERIFYING THE LOSS OF SHARE CERTIFICATES FOR ISSUING DUPLICATE SHARES (Please type this Affidavit after carefully reading the notes mentioned below the format) AFFIDAVIT I, son/daughter/spouse of aged, residing at, do hereby solemnly affirm and declare as under: That I/We, Shri/Smt. (Name of the shareholder/s), am holding equity shares in (the name of the company) covered under Folio No. and Share Certificate No(s)., bearing Distinctive Nos. to of the face value of Rs. /- each. Folio No. Certificate Nos. Distinctive Nos. Shares covered in each certificate That Shri/Smt. (name of the shareholder) has not sold, transferred, pledged or otherwise disposed off the said shares. 3. That the share certificate No(s). of the said shares has/ have been lost or mislaid and is not in my/our possession. 4. I/We have searched or caused searches to be made for the said certificate(s), but even after careful and diligent search, I /We have been unable to find out or trace the same. 5. Since the said certificate(s) was / were issued, I /We have not sold, mortgaged, pledged or otherwise encumbered or disposed of the said shares or parted with the possession of the said certificates in any manner and the said shares is / are my/ our absolute property. The best of my/ our knowledge and belief, the said certificates has/ have either been lost or been accidentally destroyed. In case at any time I / We find the said Share Certificate(s) or any of them I /We shall immediately handover the same to the Company. 6. I have already executed indemnity bond for issuing duplicate shares in lieu of the original share certificates for the aforesaid shares held by me/us. 7. I therefore request the (Name of the Company) to issue duplicate shares in lieu of the original share certificates for the aforesaid shares I am executing this declaration to be submitted to the concerned authorities of the Company. I hereby state that whatever is stated herein above are true to the best of my knowledge. Solemnly affirmed at ) On this day of ) (Signature of the Applicant/s) Deponent Identified by me Before Me Advocate S.E.M./ Oaths Commissioner/Notary
5 NOTES: Affidavit should be on Non-judicial stamp paper of Rs.100/-, if the shareholder resides in Maharashtra and he resides anywhere in rest of India it should be on NJS of Rs.20/-. Please fill up the details as per the documents you are annexing. Please do not just type this format as it is. 3. Affidavit should be attested by Notary/S.E.M/Oaths Commissioner
6 DRAFT OF NOTICE TO BE PUBLISHED IN THE NEWSPAPER CIRCULATED IN PUNE KIRLOSKAR OIL ENGINES LIMITED Regd. Office : Laxmanrao Kirloskar Road, Khadki, Pune LOSS OF SHARE CERTIFICATE(S) Notice is hereby given that the following Share Certificate(s) pertaining to Equity Shares of Rs../- each of KIRLOSKAR OIL EINGINES LIMITED Regd. Office : Laxmanrao Kirloskar Road, Khadki, Pune , registered in the name of below mentioned shareholder(s), have been reported to have been lost/ misplaced/ stolen and that the application(s) for issue of Duplicate Share Certificate(s) in respect thereof have been received by the Company. Folio Registered Share Distinctive No(s) No. No. of Shareholder(s) Cert.No(s). From - To Shares The public are hereby cautioned against dealing in any way, with the above Share Certificate(s). If within 15 days from the date of Publication hereof no claim is received by the Company in respect of the said Share Certificate(s), Duplicate Share Certificate(s) will be issued and there- after no claim will be entertained. For KIRLOSKAR OIL ENGINES LIMITED SD/- MS. SMITA RAICHURKAR Asst. Company Secretary PUNE DATE :
To, The Company Secretary, (Name of the Company ) Address of the Company
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